Achieving clarity in 2006

Article

I have been disappointed by the outcomes of anti-VEGF monotherapy. I feel that far too many retreatments are required with no clear specified endpoint

If it was this time last year and we were to predict what would be the key area of activity in the vitreoretinal segment of ophthalmology in 2006, there is no doubt that we would have predicted a big change in the way that neovascular (wet) age-related macular degeneration (AMD) is treated. This year certainly did not disappoint. Having proven itself to be a winner in the treatment of cancer, angiogenesis therapy took centre stage for research and development (R&D) in AMD.

Wet AMD: two stars launched

February saw the approval of the first anti-angiogenesis therapy for the treatment of wet AMD, Macugen (pegaptanib sodium injection) - the result of a joint collaboration between Pfizer and OSI Pharmaceuticals. (OSI has since announced that it intends to remove itself from the eye disease market).

Lucentis (ranibizumab; Genentech/Novartis), on the other hand, is a potent vascular endothelial growth factor (VEGF) binding derivative of the bevacizumab molecule (Avastin). Originally, the creators of Avastin, Genentech, reported that the bevacizumab molecule was too large to penetrate from the vitreous deep into the retinal layers. Subsequent uncontrolled studies, however, have shown that the clinical efficacy of bevacizumab is likely to be very similar to that of ranibizumab.

Avastin still making the headlines

As a result, the extreme interest in Avastin carried into 2006, with many investigators publishing reports of the benefits of this agent in the treatment of wet AMD, when administered by intravitreal injection. So far so good, is the general consensus, with the off-label agent inducing improvements in vision with no significant adverse events being reported. One study reported at this year's ARVO meeting found that the use of Avastin in patients with choroidal neovascularization (CNV) resulted in visual acuity increases and significant decreases in macular oedema. Additional retrospective research has also indicated that Avastin may be effective in other forms of neovascular AMD. It should be noted, however, that Avastin, while widely used by ophthalmologists, has not undergone the same rigorous clinical testing as Lucentis or Macugen for the treatment of wet AMD.

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Christine Curcio, PhD, of the University of Alabama at Birmingham Heersink School of Medicine, shares histology update and revised nomenclature for OCT with Sheryl Stevenson of the Eye Care Network and Ophthalmology Times
SriniVas R. Sadda, MD, FARVO, shares key points from his retina presentation at the International SPECTRALIS Symposium
Robert Sergott, MD, describes fluorescence lifetime imaging ophthalmoscopy (FLIO) and the International SPECTRALIS Symposium – And Beyond (ISS) in Heidelberg, Germany.
Anat Loewenstein, MD, describes her presentation on remote imaging for age-related macular degeneration and geographic atrophy at the International SPECTRALIS Symposium, in conversation with Hattie Hayes of Ophthalmology Times Europe
Tyson Brunstetter, OD, PhD, a US Navy Aerospace Optometrist at the NASA Johnson Space Center in Houston, Texas, shares key takeaways from his keynote at the International SPECTRALIS Symposium (ISS)
Viha Vig, MBChB graduate student at the University of Auckland, New Zealand, discusses her poster presentation on the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia.
Alfredo Sadun, MD, PhD, chief of Ophthalmology at the Doheny Eye Institute, University of California Los Angeles, shared exciting new research with the Eye Care Network during the Association for Research in Vision and Ophthalmology (ARVO) meeting on the subject of Leber hereditary optic neuropathy (LHON).
At this year's Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Utah, Nitish Mehta, MD, shared highlights from his research documenting real-world results of aflibercept 8 mg for patients with diabetic macular oedema.
ARVO 2025: Anat Loewenstein, MD, shares data from herself and her colleagues on meeting needs of patients with diabetic retinopathy
A photo of Seville, Spain, with the Congress on Controversies in Ophthalmology logo superimposed on it. Image credit: ©francovolpato – stock.adobe.com; logo courtesy COPHy
Related Content
© 2025 MJH Life Sciences

All rights reserved.